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Objective: To evaluate the incidence, treatment, and survival outcomes of Swyer syndrome with gonadal non-dysgerminoma malignant germ cell tumor (MGCT-NDG). Methods: A retrospective study was performed on Swyer syndrome patients with MGCT-NDG between January 2011 and December 2022 in Peking Union Medical College Hospital to investigate their characteristics and outcomes. Results: A total of 15 patients (4.9%, 15/307) with Swyer syndrome were identified in 307 MGCT-NDG patients. The average age at diagnosis of MGCT-NDG and Swyer syndrome were (16.8±6.7) and (16.7±6.6) years, respectively. Six cases were preoperatively diagnosed as Swyer syndrome, of which 4 cases received bilateral gonadectomy with or without hysterectomy, while the other 2 cases underwent removal of gonadal tumor and unilateral gonadectomy with hysterectomy, respectively. Of the 9 patients postoperatively diagnosed as Swyer syndrome, unilateral gonadectomy, removal of gonadal tumor, and unilateral gonadectomy with hysterectomy were performed in 6 patients, 2 patients, and 1 patient, respectively. Mixed malignant germ cell tumor (MGCT;10 cases), yolk sac tumor (4 cases), and immature teratoma (1 case) were the pathological subtypes, in the descending order. There were International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ in 6 cases, stage Ⅱ in 3 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case, respectively. Eleven patients received reoperation for residual gonadectomy after a average delay of (7.9±6.2) months, including 8 MGCT-NDG patients and 1 gonadoblastoma patient, no tumor involved was seen in the remaining gonads in the other 2 cases. Ten patients experienced at least one recurrence, with a median event free survival of 9 months (5, 30 months), of which 2 patients received surgery only at the time of initial treatment. All patients with recurrence received surgery and combined with postoperative chemotherapy. After a median follow-up of 25 months (15, 42 months), 10 patients were disease-free, 3 patients died of the tumor, 1 died of side effects of leukemia chemotherapy, and 1 survived with disease. Conclusion: The incidence rate of Swyer syndrome in patients with MGCT-NDG is about 4.9%; timely diagnosis and bilateral gonadectomy should be emphasized to reduce the risk of reoperation and second carcinogenesis in this population.
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Female , Humans , Retrospective Studies , Gonadal Dysgenesis, 46,XY/surgery , Gonadoblastoma/surgery , Neoplasms, Germ Cell and Embryonal/surgery , Ovarian Neoplasms/pathologyABSTRACT
<p><b>BACKGROUND</b>Acute minor ischemic stroke (AMIS) or transient ischemic attack (TIA) is a common cerebrovascular event with a considerable high recurrence. Prior research demonstrated the effectiveness of regular long-term remote ischemic conditioning (RIC) in secondary stroke prevention in patients with intracranial stenosis. We hypothesized that RIC can serve as an effective adjunctive therapy to pharmacotherapy in preventing ischemic events in patients with AMIS/TIA. This study aimed to investigate the feasibility, safety, and preliminary efficacy of daily RIC in inhibiting cerebrovascular/cardiovascular events after AMIS/TIA.</p><p><b>METHODS</b>This is a single-arm, open-label, multicenter Phase IIa futility study with a sample size of 165. Patients with AMIS/TIA receive RIC as an additional therapy to secondary stroke prevention regimen. RIC consists of five cycles of 5-min inflation (200 mmHg) and 5-min deflation of cuffs on bilateral upper limbs twice a day for 90 days. The antiplatelet strategy is based on individual physician's best practice: aspirin alone, clopidogrel alone, or combination of aspirin and clopidogrel. We will assess the recurrence rate of ischemic stroke/TIA within 3 months as the primary outcomes.</p><p><b>CONCLUSIONS</b>The data gathered from the study will be used to determine whether a further large-scale, multicenter randomized controlled Phase II trial is warranted in patients with AMIS/TIA.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov, NCT03004820; https://www.clinicaltrials.gov/ct2/show/NCT03004820.</p>
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Objective To investigate the feasibility of using 3. 0T MRI multi-echo (ME) Dixon technique for liver fat quantification in patients with nonalcoholic faity liver disease (NAFLD). Methods Twenty volunteers were enrolled in this prospective study, and they included 16 NAFLD patients (12 males and 4 females) and 4 healthy volunteers (3 males and one female). All volunteers were examined by routine liver MRI. VIE Dixon technique and single-voxel MRS. After examination. the fat fraction (FF) value of Screening Dixon and the FF value of single-voxel MRS with Histo sequence were recorded, and the FF values of 3 regions of interest (ROIs) in the fat fraction map of ME Dixon were manually measured Finally, the FF values were analyzed with Spearman correlation analysis. Results The Screening Dixon FF value was positively correlated with the FF values of three ROIs of ME Dixon (r = 0. 842. 0. 959. and 0. 945 respectively, all P<0. 001). Similarly, positive correlation was also found for the FF values of Screening Dixon and 3 ROIs of ME Dixon with the FF value of single-voxel MRS with Histo sequence(r=0. 971, 0. 842, 0. 959. and 0. 945 respectively,all P<0. 001). Conclusion h is feasible to use 3. 0T MRI ME Dixon for evaluating liver fat content in patients with NAFLD. and iis results are positively correlated with those of single-voxel MRS. It is valuable for the diagnosis, follow-up and intervention of NAFLD patients.
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<p><b>OBJECTIVE</b>To investigate the expression of translationally controlled tumor protein (TCTP) in human breast cancer tissues and its clinical significances.</p><p><b>METHODS</b>The expression of TCTP in 94 human breast cancer and the corresponding adjacent normal mammary tissues were detected using immunohistochemistry.</p><p><b>RESULTS</b>The expression rate of TCTP was 64.89% in human breast cancer tissues, significantly higher than that in normal benign mammary tissues (39.36%, P<0.001). TCTP overexpression was positively correlated to the tumor size, clinical stage, lymph node metastasis and histological grade of breast cancer (P<0.05). Patients with positive TCTP expression had a significantly shorter mean survival time than those with negative expression (P<0.001).</p><p><b>CONCLUSION</b>TCTP may play an important role in the tumorigenesis and development of breast cancer, and can be an important prognostic factor for this malignancy.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Biomarkers, Tumor , Metabolism , Breast Neoplasms , Metabolism , PathologyABSTRACT
Objective To describe the distribution of road traffic injuries through hospital based National Injury Surveillance System (NISS). Methods Data of road traffic injuries was descriptively analyzed from Chinese NISS from 2006 to 2008. Results In 2006-2008, road traffic injury was the second leading cause from NISS among attendants in ERs or clinics of the hospitals,with males (64.63%, 64.07%, 64.38% ) more than females (35.37%, 35.93%, 35.62%). People aged 30-44 (36.04%, 34.82%, 34.28% ), 15-29 (30.74%, 31.57%, 30.13%), 45-64 (20.28%, 20.70%,22.80% ) years were seen more than other age groups. The majority of road traffic injuries were unintentional (98.34%, 99.07%, 99.07% ), and mostly injured in head (35.21%, 33.74%, 35.77% )and lower limbs (24.08%, 24.54%, 23.95%) which mainly as bruise (56.47%, 57.92%, 58.89%) and fractures (17.70%, 15.84%, 15.88% ). The severities of injuries were mainly minor ones (63.69%,67.24%, 65.68% ), and mostly went home right after treatments (59.43%, 63.76%, 62.80% ).Conclusion The distribution of road traffic injuries from NISS kept stable from 2006 to 2008. Young and middle aged men were the focus population for road traffic injuries intervention. Further improvement ofNISS, multi-sectional collaboration-based advocacies and education programs as well as the enforcement of road safety law seemed the good practices for road traffic injury prevention.
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Objective To analyze the injury characteristics, using data from the National Injury Surveillance System (NISS), 2006 to 2008, to develop a injury prevention strategy. Methods 129 hospitals from 43 surveillance points in NISS were selected according to the DSP sample framework, also considering the capacity of local CDC. Results Relative information on 1 318 739cases were analyzed. The number of male cases were more than the females. The top three causes of injuries were as follows: falls (28.02%,29.36%,30.12%), traffic-related (23.07%,21.61%,21.44%)and blunt injuries (21.46%, 21.17%, 20.59% ). The major places where injuries occurred were: road/street (29.80%, 27.73%, 28.37% ) and at home (21.51%, 22.80%, 24.02% ). Recreation activities (35.63%, 41.93%, 42.13% ) and at work (24.43%, 22.60%, 21.44% ) were the two major activities when injuries took place. Most injury cases were unintentional (83.81%, 86.32%, 86.71% ) and mild (70.42%, 74.79%, 73.90% ). Rush hours that caused injuries to happen were between 7 to 10 AM.Conclusion Male injury cases were more than females. Falls, road traffic-related and blunt injuries were the major causes, with most of them were unintentional and minor.
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Objective To describe the distribution of injuries among the elderly through hospital based National Injury Surveillance System (NISS), and to provide basic information for prevention of injury among the elderly. Methods Data on injuries among the elderly aged 60 years and above was descriptively analyzed from the Chinese NISS from 2006 to 2008. Using the data of NISS from 2006 to 2008, information was collected on those cases who were diagnosed as injuries for the first-time in the site hospitals. Information included demographic characteristics, features of the injury events, and clinical characteristics of injuries. SPSS 16.0 software was used for data analysis.Results The leading causes of injuries among the elderly were: falls, road traffic injuries, and blunt injuries, which were in total accounting for more than 70% of all the injuries among the elderly. Most of the injuries occurred at home (46.25 %, 44.44%, 46.23 % ), on the roads ( 30.95%, 28.51%, 28.61% )and in the public residences (8.89%, 11.57%, 11.25% ). Recreation activates (42.14%, 48.09%,48.59%) ,housework/study (21.15%, 18.21%, 18.15%) and driving (13.67%, 13.80%, 13.56%) were the three major activities when injuries took place. Most injuries among the elderly were unintentional (91.34%, 92.84%, 93.09% ). The leading causes of suicide of the elderly were poisoning and sharp injury. The most common natures of injuries were bruise (36.07%, 38.18%, 38.50% ), fractures (25.65%, 22.47%, 23.77% ), and sharp/bite/open injuries ( 17.19%, 18.21%, 17.46% ) while the most injured part of bodies were head (26.32%, 25.59%, 25.90%), lower limbs (25.74%, 25.70%, 25.26%)and upper limbs (21.01%,21.14%,21.37%). Most of the injuries were minor ones (60.53%,65.09%,63.58% ), and patients mostly went home after treatment (64.11%, 68.53%, 67.99% ). Conclusion According to NISS, the proportion of injuries among the elderly in all injuries kept increasing from 2006 to 2008, while distribution of injuries among the elderly being stable. Falls was the most common injury type for the elderly which also brought along bad outcome. Falls was the priority for injury prevention among the elderly.